Let's talk simply about Rectal Prolapse and Surgery (Rectopexy)

Do you sometimes feel a lump or a heaviness in your rectum after going to the bathroom? Does it feel like something inside has come out? This is what we call rectal prolapse . Although it is a difficult and embarrassing topic to talk about, it is very important for your well-being. So let's talk about it openly.

What exactly is this? Simply put...

Think about it, the last part of your colon is called the rectum. Normally, it is held in place by the muscles inside your pelvis. But sometimes, when these muscles become weak, the rectum slips down a little and tries to pop out of your anus. It's like a sock turning inside out. This is what we call Rectal Prolapse.

This condition is not a medical emergency. However, if left untreated , it can get worse over time. This can lead to pain, bowel problems (constipation or incontinence), and other complications.

Who is more likely to experience this condition?

This is not a very common condition. Although it can develop in anyone, it is most common in women over the age of 50. It can also occur after pregnancy, in people with long-term constipation, or after an injury.

What types of surgeries are available for this?

The only way to cure Rectal Prolapse in an adult is through surgery. This surgery is called Rectopexy . There are two main types of surgery. Your doctor will choose the best method for you based on your health, age, and the severity of the problem.

Abdominal Procedures

During this surgery, you will be put under general anesthesia. There are several methods for this:

• Open surgery (Abdominal Rectopexy): The doctor makes a long incision in your abdomen, pulls the prolapsed rectum back up, and secures it to the back wall of your pelvis (sacrum) with permanent stitches or sometimes a mesh sling. Over time, scar tissue forms and it stays there permanently. Sometimes, a bowel resection (surgery to remove part of the bowel) may be done to reduce constipation.
• Laparoscopic Rectopexy: Instead of making a large incision in the abdomen, this surgery is performed by making a few small incisions and inserting a thin tube with a camera attached (laparoscope) and other instruments.
• Robotic Rectopexy: This is similar to keyhole surgery, but a robotic device is used to assist the doctor.

Perineal Procedures

This surgery is usually performed on older people or those who have other medical conditions that make it difficult for them to undergo major surgery. It can be performed under general anesthesia or with an epidural.

• Altemeier procedure: In this procedure, the doctor removes the prolapsed rectum and the last part of the intestine through the anus, cuts them out, and then reconnects the remaining rectum to the intestine.
• Delorme's procedure: This is usually done for minor prolapse. Here, only the lining of the rectum is removed, the muscle layer is folded, and it is sewn back into the anal canal. This thickens the muscle wall and stops the rectum from slipping out of place.

How do you prepare before surgery?

It is essential that you follow your doctor's instructions carefully before surgery. Typically, you will be asked to do the following:

• Eat only liquids the day before surgery.
• Stop taking certain medications (especially blood thinners) for a while.
• Take laxatives to cleanse the intestines thoroughly.

What can you expect after surgery?

You will need to stay in the hospital for a few days after the surgery. If you had surgery through your abdomen, you may need to stay for about a week. Your doctor will monitor you until you are able to eat normally again, pass gas, and have a bowel movement. This is to make sure your digestive system is working properly again.

Here are some common symptoms in the first few days after surgery:

• Feeling pain or tightness in the anus and incision areas.
• Slight bleeding or passing a little blood with the stool.

How do you choose the surgery that best suits you?

This is determined by your doctor. Several factors influence this.

Aren't there any risks to this surgery?

As with any surgery, there are risks. For example, bleeding, blood clots, and infection. Although abdominal surgery carries a slightly higher risk, the risk of recurrence is much lower with that procedure . Perineal surgery carries a lower risk, but the risk of recurrence is higher.

Some complications specific to the surgery may include:

• Anal fistulas
• Anastomotic leak
• Intestinal obstruction
• Sexual function problems
• Constipation increases further

Recovery time after going home

It can take several weeks or months to fully recover after you return home from the hospital. It will take some time for your bowel movements to return to normal. During this time, you should take care of the following:

• Avoid constipation: Eat plenty of fiber-rich foods (vegetables, fruits). Drink at least 8-10 glasses of water a day.
• Avoid straining: Never strain hard while using the toilet.
• Stool softeners: If your doctor recommends it, use stool softeners.

When do you want to see the doctor again?

If you experience any of the following symptoms, notify your doctor immediately:

• Excessive rectal bleeding.
• Severe or persistent constipation.
• Symptoms of rectal prolapse (feeling heavy, lumpy).
• Signs of infection (fever, redness of the incision, swelling).

You may feel embarrassed to talk to a doctor about something like this. But remember, Rectal Prolapse is not a condition that can be cured without surgery. The longer you delay seeking treatment, the worse the problem can get. So, if you have these symptoms, don't be afraid to see a doctor and talk to him. That way, you can recover quickly and live your life comfortably again.

Rectal Prolapse, Rectopexy, Rectal Surgery, Constipation, Surgery, Colorectal Surgery